How many antique/classic vehicles are in your household?

1 2 34 5 or more

What is your age?18 – 25 26 – 3940 – 55 Over 55

How many years have you been aCoker Classic® tire owner?

First timeLess than 5 yearsMore than 5 years

How did you first hear about thispromotion? (Please check one.)

Direct mail RadioNewspaper TelevisionSalesperson in store WebsiteIn-store display EmailWord of mouth CatalogOther

Which of the following was animportant contributing factor inyour most recent purchase ofCoker Classic® tires? (Check allthat apply.)

Promotion/saleDealer recommendationFriend/relative recommendationQuality of productActual tires on displayTires in stockOnline research(reviews, websites, etc.)Replacing another set of Coker Classic® tires Replacing a different brand of tires

Buy a set of four (4) select Coker Classic® Wide Whitewall Radial tires between August 15, 2017 and November 15, 2017, and get a $60 rebate after form submission!*

How to receive your $60 rebate:• Purchase tires from Coker Tire or a participating dealer.• Print this form online at cokertire.com/ccrebate and fill it out completely.• Attach original receipt showing the purchase of four new select Coker Classic® tires within the offer period.• Mail completed rebate form and original receipt to:

Coker Classic RebateCoker Tire1317 Chestnut StChattanooga, TN 37402

To learn more, call 866-784-2170.Offer valid on purchases made from 8/15/17 - 11/15/17. Form must be received by 11/30/17.

OPT-OUT

Where did you buy your tires? (Dealer Name)

Date of Purchase Mo. Day Year

Year of Vehicle Make (e.g., Ford) Model (e.g., Mustang)

Email Address

First Name Last Name

Address Apt./Suite Number

City State ZIP Code

Phone

The last four digits of the phone number are required for rebate processing.

What is the next vehicle you plan to purchase tires for?

Year of Vehicle Make (e.g., Ford) Model (e.g., Mustang)

When do you expect to purchase tires for this vehicle? (Please check one.)

In the next 30 days 31 to 90 days from now 91 days to 1 year from now More than 1 year from now

$60 REBATE FORM

1) Completed rebate form 2) Original receipt showing purchase of 4 qualifying tiresChecklist for proper rebate submission:

*Offer valid for residents of the United States only who purchase from a participating dealer located in the fifty (50) United States, District of Columbia (“U.S.”) and U.S. Territories (Puerto Rico, Guam and U.S. Virgin Islands). Purchase must be completed between 08/15/2017 and 11/15/2017. Limit of one (1) redemption request per purchase of four (4) new select Coker Classic® tires. Limit of three (3) redemptions per household. Must be at least 18 years of age or older at the time of purchase to be eligible. All requests must be postmarked or received on or before 11/30/2017. Please allow four (4) to six (6) weeks for delivery of the $60 rebate via mail. Sales to Original Equipment manufacturers, fleets, wholesalers, business accounts and purchases for resale are not eligible for this promotion. All decisions made by Coker Tire (or its authorized representatives) relating to the validity of any submissions are final and binding. This promotion is subject to all federal, state and local laws and regulations. Coker Tire reserves the right to modify or discontinue this offer, products and/or services at any time for any reason. No cash refunds. Please retain copies of the materials you submit. All requests become the property of Coker Tire and will not be returned. Coker Tire is not responsible for any lost, late, stolen, damaged, misdirected, incomplete, incorrect or illegible mail. No postage-due requests. For questions regarding this promotion, please call 866-784-2170 Monday through Friday between 8:00 a.m. and 8:00 p.m. ET. Offer may not be assigned, traded, sold or combined with any other Coker Tire offer. THIS OFFER IS NOT VALID WHERE PROHIBITED OR RESTRICTED BY LAW.Copyright © 2017 Coker Tire. All rights reserved.

I do not want email notifications about special offers and promotions from Coker Tire.Coker Tire has a very strict privacy policy. We do not sell or rent your personally identifiable information to third parties.

Rebate applies to these item numbers:

Wide White Wall 52605553030053890054609056874557986579400587050597020629700

16” Bias Profile 64308643096223862239622426224362244622456224662247